Menopause can have some big impacts on a woman. It is the time in life when menstruation has ceased signaling the end of the reproductive phase of life.
It also is the time when a woman’s risk of heart disease increases significantly. “Menopause doesn’t cause the increased risk,” says John Ryan, MD, a cardiologist with University of Utah Health Care (UUHC). “It just happens that both happen at around the same time of life. Women in their mid-50s are likely entering menopause — and that is also when heart disease risk increases.”
What does menopause do to your body?
One of the big things you hear about when talking about menopause is the drop in estrogen. This is what causes hot flashes, vaginal dryness, mood swings, and other symptoms you may see discussed on lifestyle blogs.
However, it also causes other changes to the body that aren’t discussed as often. “The decreased estrogen does promote increased visceral or abdominal fat, which can increase insulin resistance, cholesterol and metabolic syndrome,” says Corrine Welt, MD, an endocrinologist with UUHC. “All of these changes increase heart disease risk.”
Don't turn to hormone replacement therapy
While the loss of hormones can lead to changes that increase the risk of heart disease, replacing those hormones is not the answer. Many women choose to go on hormone replacement therapy in order to retain their sex drive or keep their metabolism in check. There is no shortage of advertisements extolling the benefits of these programs – and at one point it was believed that hormone replacement could improve heart health and possibly fight dementia.
However, that was proven incorrect by a large clinical trial that found no proof of hormone replacement helping with disease prevention. “The Women's Health Initiative was the largest study that examined estrogen replacement for primary prevention of heart disease,” says Welt. “Estrogen did not show any benefit in preventing heart disease in that study.”
In fact, while they may be safe for helping with menopause symptoms like hot flashes, replacement hormones have been associated with an increased risk of heart attack and stroke in women.
Instead, drop bad habits
Instead, it is better to focus on the physical changes being caused by aging, decreased exercise and the loss of estrogen — like weight gain and fat redistribution. Such weight gain can cause an increase in blood pressure — which is naturally rising anyway due to changes happening in the vascular system. “As you age your vascular tone increases,” says Ryan. “Your blood vessels become tenser — less flexible. Bad habits start catching up with you and start having an impact on your heart.”
Dropping those bad habits is key to improving your heart health. That’s good advice for everyone, not just women approaching or in menopause. Eat a balanced diet high in fruits and vegetables. Lay off the red meat and instead add fish and lean meats into your meal plan. Get enough exercise – at least 150 minutes every week. Don’t smoke, or quit smoking if you started.
“You should take care of your heart throughout life,” says Welt. “Be aware of your family history; if there is heart disease or high cholesterol make sure that you get preventive care to avoid developing heart disease.”
Of course, if you haven’t lived the healthiest of lives, menopause may be a good time to take stock and start making changes that you should have made previously. “It’s never too late,” says Ryan. “Use this event to think about your health. Even if you’ve been diagnosed with heart disease you can make changes.”
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